What’s new in general surgery: transplantation

Knowledge and willingness toward living organ donation: a survey of three universities in Changsha, Hunan Province, China

BACKGROUND

This study was conducted to clarify the knowledge and attitudes of Chinese university students regarding living organ donation and analyze the determinants impacting their decisions.

METHODS

A questionnaire was delivered to college students chosen by random assignment. The data was analyzed by Statistics Package for Social Science (SPSS) software.

RESULTS

Of 434 participants, 49.8% indicated they would be willing to be living organ donors, 58.4% believed living organ donation could ease the organ shortage, 48.2% thought that the recovery rate of recipients of living organ donors transplants was equal to or even better than deceased donation, 62.4% designated relatives as their most probable recipients, 48.0% argued that partial compensation was an effective method to increase live organ donation, and 53.7% wished to donate through transplantation centers. According to univariate analysis, attitudes regarding the value of life, relationship between body integrity and health as well as body integrity and conventional culture were factors that impacted on an individual's decision. Students' knowledge of the value of living organ transplantation and their economic background were considered to be determinants of individual willingness. Furthermore, the operation's impact on quality of life and postoperative complications were additional concerns. Multivariate analysis indicated that other factors influencing students' willingness to donate included attitudes toward the relationship between body integrity and health, beliefs regarding body integrity and conventional culture, value of living donor organ transplantation, economic background of students, and anxiety about the impact on postoperative complications.

CONCLUSIONS

Numerous students were willing to participate in living organ donation. At the same time, social education and advertisements for living organ donation were far from adequate, having little or no influence on the decision-making process.

Living donor kidney transplantation in a Veterans Administration medical center

BACKGROUND

A shortage of organ donors remains the major limiting factor in kidney transplantation. Living donor renal transplantation, especially living-unrelated donors, may expand the donor pool by providing another source of excellent grafts.

METHODS

Between 1983 and 2003, 109 living donor kidney transplants were performed. Potential donors were assessed with a standardized routine. Antithymocyte serum (N-ATS) and Basiliximab were used as induction agents. Sandimmune, Gengraf, Neoral, and Prograf were the main immunosuppressants with Immuran, Mycophenolate Mofetil, and steroids. Eighty-two percent of the recipients were from out of state.

RESULTS

Seventy-eight percent of the living donors were from living-related donors and 22% were from living-unrelated donors. One- and three-year patient survival rates were 97.6% and 93.2% with 1- and 3-year graft survival rates of 93.2% and 88.3%, respectively. There were 6 delayed graft functions (5.5%), 16 acute cellular rejections (10%), and 10 chronic rejections (9%). Twelve patients died, 7 of them with a functioning graft. In the past 6 years (1997-2003), the number of living donor kidney transplants surpassed deceased donor kidney transplants.

CONCLUSIONS

Because of the limited number of cadaveric kidneys available for transplant, living donors represent a valuable source, and the use of living-unrelated donors has produced an additional supply of organs. In our program, the proportion of living donors used for kidney transplant is comparable with other non-Veterans Administration programs and the survival of these allografts appears to be superior to deceased donor kidney transplants.